Change of Heart

by Sally Mandel

  Walter snorted, and after a moment Diller said, “I can call in a couple of people, but I think they’ll agree. I’m sorry.”

  There was another long silence.

  “I think it’s time we discuss the possibility of a heart transplant,” Margaret said.

  Both men gaped at her until finally Diller responded, “But your daughter won’t give us permission.”

  “Probably not,” said Margaret.

  “She isn’t a minor,” Diller protested, and at this Walter exploded.

  “You should have done it when she was a minor. She’d be walking around with a halfway decent heart instead of that hunk of flab.”

  Diller forced himself to remember the architect’s cost estimates for the projected artificial-heart laboratory and controlled his voice. “If you remember, the last time we discussed transplantation, you decided against it yourselves.”

  “With a lot of prodding from you and your chicken-shit buddies.”

  They all sat quietly another moment. Ceasefire, thought Diller, waiting with clenched teeth for the next outburst. But there was none.

  Margaret Converse looked him full in the face and said, “I’ll see to it that you get your permission.” Then she turned to Walter. Her expression was polite and cold, and Diller found himself wondering what their sex life was like.

  “Does that conform to your thinking, Walter?”

  “What?” said Walter dully.

  Margaret repeated, “The transplant. Do you agree we should do it?”

  Walter nodded.

  “Then you do whatever you have to do, Doctor Diller, and we’ll do whatever we have to do.”

  “It’s not that simple, Mrs. Converse. There’s a lot of arranging—”

  “Whatever’s necessary,” she interrupted crisply, then stood up and left the room without another word.

  Well, I’ll be damned, thought Diller.

  Converse sauntered after his wife with an elaborately slow pace. Once he’d disappeared, the doctor went back to his X rays and stared at them balefully as if they were his mortal enemy.

  Margaret and Walter sat downstairs in the hospital cafeteria. They were alone except for an oversized young woman in a print housedress with her two unruly children. Margaret watched her slap at their hands and wearily push her straggly blond hair behind her ears.

  “How come you never listen to me, Buddy? How many times I gotta tell youse kids? Don’t I speak English or what?”

  “Close,” Margaret murmured under her breath. Walter looked up from his coffee cup to stare at her with a puzzled expression. She ignored him, and pretty soon he slipped back into his preoccupied munching. My God, she thought, he looks like a shaved buffalo.

  Margaret flashed back again to the scene that still clung to her consciousness, attaching itself to her memory like a dark, exotic creature with fierce little claws. It was a slow-motion scene, with Walter blasting away at one end of the dining room table and Sharlie standing pale and quivering, defying him with huge glistening eyes. And suddenly she’d crumbled. Not a heavy-bodied crash to the floor, but almost as if someone had pulled a vital plug and all the essence of the girl hissed out, leaving a loose pile of clothes in a heap beside the chair.

  At that precise moment Margaret had heard an audible snap inside her head. A tightrope would give way like that, with a sharp, metallic retort, and like the lady in the tutu, she began to tumble, her pink, frilly parasol useless against the powerful force of gravity. On her way down, she found that she had no curiosity about a net—whether or not it was there. She had lived with such intense fear for so long that now, in the midst of the disaster she’d always dreaded, she no longer cared what happened to her. Only the fall itself mattered, and she felt a thrilling exhilaration all the way down.

  She glanced at Walter again now, and felt the same excited pounding in her head. If he had tried to touch her then, I would have picked up a steak knife and stabbed him through the heart.

  “What’s the matter, Margaret? Your gut bothering you again?”

  Margaret stared at him from far away, across the vast Formica surface of the cafeteria table. Goodness, she thought, how long has the man been losing his hair?

  He saw her gaze fastened on the top of his head, and swiped at his hair curiously, wondering if there were a thread or speck of lint there. He shifted uncomfortably.

  “Goddamn granite, these seats. Only fit for people with fat asses.” He looked pointedly at the woman with the two children, strewing food and paper napkins in an ever-widening orbit around their table.

  What the hell’s gotten into Margaret anyway? he thought, inspecting her surreptitiously as she tipped her teacup and drained off the last drop, her little finger extended just slightly in a manner that he enjoyed mimicking. He could almost always get a smile out of her with the performance, but something told him not to try it today.

  “I’m going back to the waiting room,” she said. She got up abruptly, smoothed her soft gray skirt, and left him sitting there to stare after her. She stood very straight as she walked toward the cafeteria exit, and it seemed to him there was a more loose-limbed spring in her walk.

  Just who the hell did she think she was, leaving him here without even a consultation about the next move? To hear her talk to Diller, you’d think she was the one who’d run the show all these years, who’d made all the agonizing decisions, who’d held his hand while he whimpered and whined and leaned on her for every little thing. Maybe the strain was finally too much—Sharlie’s illness—and this time she’d had some kind of mental breakdown. Except that she looked so goddamn put together. Crazy people didn’t function like that. Unless she’d turned into one of those nuts who thinks she’s Queen Victoria.

  The dreaded image flashed into his mind again—the two women, one unconscious on the rug, one crouched over the inert body like an animal protecting her wounded young, glaring at him in white-faced fury, ready to pounce at his slightest movement. He kept trying to force the memory away, but its impact became stronger as the hours passed. He found it impossible to sit still when the scenario recurred in his head. Bedeviling faces, one as white as death, the other a portrait of hatred.

  He shook his head and looked up, hoping to distract himself with the sight of the slovenly family sitting nearby. But their table was empty—not one scrap of litter remained behind.

  Suddenly he could no longer bear the idea that Margaret was upstairs, maybe learning some piece of news before he did. This time she hadn’t consulted him about anything, much less the usual niggling details that used to drive him crazy—whether to raise or lower Sharlie’s bed, and if so, how far; what magazines to bring her to read when she was up to it again; or maybe she’d like a newspaper, but wouldn’t that be too upsetting?

  Imagine Margaret just getting up like that and leaving him down here. He’d have to speak to her about their joint responsibility and the need for communication. He’d bring it up as soon as she wasn’t acting quite so flaky.

  Chapter 21

  Brian’s fear catapulted him up Third Avenue as if he were a wad of paper shot out of a giant rubber band. Despite the almost wintry chill of the April afternoon, he arrived at Saint Joseph’s with body steaming. He eyed the crowd waiting for the elevator as it descended haltingly to the ground floor. Certain that the crammed cubicle couldn’t contain the anxiety exploding from his chest, he vaulted up the eleven flights to the Intensive Care Unit and raced down the hall to the waiting room.

  The sight of Walter and Margaret sitting across the room from each other stopped him at the doorway as if the atmosphere on the other side of the threshold were a solid block of ice, impenetrable. The two gazed at him, white faces marooned on separate frozen islands of animosity and bitterness. Silently Brian’s eyes absorbed Walter’s sagging shoulders, the pale-blue shirt grimy and wrinkled, and Margaret’s stiff posture, arms held tightly to her midsection, legs pressed together in a straight line. Their misery, u
nmitigated by sharing, seemed instead exaggerated by the other’s presence.

  Their fault. Whatever happened to Sharlie. Martha’s voice on the telephone half an hour ago had replied noncommittally to Brian’s urgent questions, but he had responded to the careful words with a violent and visceral hatred for Sharlie’s parents, a hatred that distracted him from his fear for her. But the angry speeches that boiled inside him all the way uptown cooled into silence now as he looked at the two guilty ones, staring from their ice block. Rather than melt that barrier with his hot rage, he turned, wordless, and walked away from their frightened eyes.

  Walter’s and Margaret’s images dissolved like puffs of cold winter breath as Brian stood gazing down at their daughter. It was Sharlie all right, but he imagined this was how she looked as a young girl, perhaps about twelve years old. Her eyelids had the translucent fragility of the very young, and her figure appeared diminished in the midst of all the wires and machinery. Her face was so still that the lines of her mouth seemed carved. There was no movement, even along the delicate curves of her nostrils. He glanced at the machines ticking steadily, marveling that somewhere in her body life continued.

  Sharlie! Open your eyes and smile at me and say something ridiculous about this place you’re in—what did you call it? The Incredibly Complicated Udder? Tell me about the mail-order heart you sent for from L. L. Bean—the down-filled one to make you extra warm-hearted. As if you needed that.

  Someone touched his shoulder, and he swung around ferociously. The startled nurse motioned that it was time to leave. He walked out through the double swinging doors into the empty corridor, and when he couldn’t think of anything else to do, he pulled back his right fist and slammed it into the wall.

  Later, in Diller’s office, he stared down at his hand, wrapped in a light plaster cast. A hairline fracture, they’d said down in X ray. Amazingly, the release of frustration seemed worth the pain and embarrassment, but he knew the relief was momentary. Every day another plaster cast, perhaps? Left hand tomorrow, feet next, then head—which took him to the weekend. He’d have to content himself with the walls in his own apartment so as not to find himself expelled from the hospital for malicious mischief.

  He knew that Walter and Margaret would not have included him in the conference, so he had just barged in and sat down with them. But now he found it difficult to pay attention. Diller’s voice droned on, something about Jason Lewis—the Santa Bel heart surgeon—tests, flight arrangements. Brian watched Walter’s hands, moving in a restless, helpless rhythm, one on top of the other in his lap.

  Then Diller was standing, so Brian rose with Margaret and Walter, and they filed out of the office in silence. Brian didn’t feel like asking, but he got the impression that Sharlie was about to leave for California.

  Sharlie swam through the pale-blue sea, only she knew it wasn’t water, it was sky. She floated easily, turning with the slightest movement of her arms. She took a quick look over her shoulder, just to make absolutely sure there were no wings. It was peaceful up here, quiet except for the faint ticking sound above her—God’s wristwatch, no doubt, she thought, and felt herself begin to giggle.

  But then the light dimmed, and suddenly she began to shiver. So cold. She tried to work her arms faster, but they were pinioned to her sides, and she started to fall, hurtling through the cold darkness toward the ticking that, below her now, grew louder and louder. She fought against the restraints, trying to free her arms so that she could perhaps cling to something to break her fall, and in her struggle she roused herself and stared straight up into Brian’s face. She gazed expressionlessly at him for a long moment, and finally, as if they were in midconversation and had been briefly interrupted by a cough or a sneeze, said in a clear voice, “Bastards won’t let me out of here.”

  Brian began to laugh, and he grasped her hand. She smiled vaguely at him, wondering why he seemed so ecstatic when she was lying around with all these wretched wires sticking out of her.

  “Where are my parents?” she asked.

  “Down the hall. Want to see them now?”

  She shook her head. “No. I’m going to sleep. Hold my hand until I go, all right?”

  He nodded, and she fell asleep almost instantly.

  The same nurse who had been on duty when Brian made his first visit to ICU stood behind him now, well out of reach of his remaining unbroken fist. “Time to go,” she said warily, eyes focused on the plaster cast.

  Brian moved reluctantly from the bedside, and the nurse backed off a bit, giving him a wide berth as he passed through the doors.

  Chapter 22

  Two days later they performed an angiogram. Sharlie lay on the table while Dr. Parkiss threaded the catheter up through an artery in her arm and down into her heart. He kept a close watch on the fluoroscopy screen as the procedure was videotaped. After a few minutes of conferring with the technicians, Parkiss, a short, swarthy man with so much hair that Sharlie thought he looked like an exotic tropical fern, said, “All right, Sharlie. You set?”

  Sharlie said, “Can hardly wait.” Then she closed her eyes.

  “Okay, boys,” Parkiss said. “This one’s a pro, so you’d better do it right. You’ll have the big guys on your ass if you screw up.”

  The heat, pleasantly soothing at first, flooded her shoulder, but soon the pressure became a throbbing, aching bulge. Parkiss stood with his hip pressed to her side, and she found his body warmth comforting.

  The assistant with the iodine looked at the monitor and whistled under his breath. Sharlie felt Parkiss stiffen next to her.

  “What is it?” she asked, and Parkiss, voice carefully neutral, murmured. “Don’t pay any attention to Iodine Ike over there. He’s just never seen a heart of gold before.”

  “I’m only listening to your hip, Doctor. You have a very eloquent hip.”

  Parkiss smiled down at her and shifted his weight slightly so that his body no longer came in contact with hers.

  “I must teach my hip to maintain itself in a professional manner.”

  “Tell me about the left ventricle,” she said.

  Another dose of hot liquid flooded her shoulder. Parkiss watched the monitor. His voice was distracted.

  “You let me worry about your left ventricle.”

  Sharlie waited until the team relaxed to make notations and said quietly, “Look, it’s my heart you’re gawking at. Can’t I know what’s happening?” Her dark eyes pleaded for honesty.

  “There’s enlargement.”

  Sharlie’s eyes flickered briefly, then faced his steadily. “Scar tissue?” she asked.

  “Yes.”

  She nodded. “Thank you.”

  Dr. Parkiss’s helplessness showed in the deep lines around his mouth. Everyone was silent as they carefully removed the catheter and turned off the machines.

  That afternoon Sharlie lay sleeping in her room. Number 1101 this time, with the sun brushing the right side of her face. She heard small clinking noises and awoke to find Ramón Rodriguez changing her IV tube. He smiled at her and winked.

  “Pretty exciting news about you,” he said, fiddling with the bottle so that it sat just right.

  “What?” asked Sharlie sleepily.

  “The transplant.”

  Sharlie didn’t answer, and Rodriguez suddenly looked down at her in horror.

  “Holy Jesus.”

  “Transplant …” Sharlie said, still only half awake, but Rodriguez watched the panic spread across her face.

  “They should take my mouth and fill it with shit and dump me back in the garbage on Avenue D,” Rodriguez said fervently, his face contorted with dismay.

  “It’s all right, Ramón,” she said softly.

  He seemed unable to move. His face was stricken. Sharlie tried to reassure him. “It’s okay, honestly. I should know what’s going on.”

  His body sagged a little with relief, and he said, “They called Santa Bel, and Diller said …”
>
  Sharlie put her hands over her ears and shook her head vehemently. Rodriguez turned and almost ran out of the room.

  “Nice flowers,” Walter said. He picked the card from its perch on a twig of baby’s breath and read it aloud: “‘Some people have too-big mouths. Love from a friend.’ What the hell is that?”

  Sharlie said, “I have a secret admirer.”

  Walter looked at his daughter. She lay there as if they were telling her she ought to have her temperature taken.

  “You don’t seem surprised,” Brian was saying, and Sharlie replied, “I watched the monitor during the catheterization this morning.”

  There was silence as they all stared at her. Sharlie’s face pleaded with Brian, and he said quietly, “Walter … Margaret … leave us a minute, all right?”

  Sharlie’s eyes widened as her parents got up.

  “We’ll have some coffee,” Margaret said, and they left the room.

  “‘Walter,’” Sharlie said in an awed voice. “‘Walter’?”

  “Well, what do you want from me? Mister-Master-Sir-Your-Majesty?”

  “I must have been dead a long time. You’re all so congenial.”

  “Unity in battle.”

  “Who’s the enemy?”

  “I hope you’re not,” he said, watching her face closely.

  She turned her eyes from him.

  “You going to fight it?” he asked.

  “I told you I wouldn’t.”

  Brian’s voice was gentle. “It’s different now that it’s for real,” he said, remembering the look on her face as she sat on his bed, the paper-napkin heart pinned to her chest and her chin smudged with ink. She nodded. “I know it’s scary,” he went on. “But, honey, if you’re not with us, you’re against us.”

  She was quiet for a long time. Then said softly, “Everybody’s holding out this carrot, and it’s going to turn into a big fat turnip.”